(SDAR) A Longitudinal Analysis of Health Care Utilization among Pregnant and Postpartum Homeless Women and their Infants
Grantee: University of Massachusetts
Principal Investigator: Robin E. Clark
Project Number: R40MC30755
Project Date: 04/01/2017
Final Report
Age group(s)
- Women/Maternal
- Perinatal/Infancy (0-12 months)
- Toddlerhood (13-35 months)
Abstract
Homeless individuals have been studied extensively in recent years, but less is known about homeless families who comprise more than one-third of the homeless population. Much of the existing data on health and healthcare use in families comes from studies conducted 10 to 20 years ago and relies on self-reports. This study will provide more specific, up-to-date, and reliable information on the health and health care utilization of homeless families with the ultimate goal of informing new interventions for women and infants. Focusing specifically on pregnant and postpartum women and their children under two years of age, we will use a dataset that links emergency housing assistance applications for homeless families between 2008 and 2015 with Medicaid claims to compare health conditions while homeless and while housed and to compare homeless family members (19,437 women; 24,753 infants) to a matched group of stably housed Medicaid members with characteristics similar to those of homeless families (13,319 women; 19,031 infants). Our specific aims are to: (1.) Describe the demographic and clinical characteristics of homeless women receiving Emergency Housing Assistance between 2008 and 2015 who have claims-based diagnoses related to pregnancy and/or childbirth (2.) Describe the demographic and clinical characteristics of infants from birth to 2 years of age who are members of a homeless family between 2008 and 2015. (3.) Develop a set of longitudinal models to explore the associations of pregnancy and maternal health with homelessness and with adverse infant outcomes. The proposed study responds to the Health Resources and Services Agency's Maternal and Child Health (MCH) Secondary Data Analysis Research announcement (HRSA 17-012) and addresses two MCH Block Grant National Performance Domains: 1) Well women visits and preconception/interconception health and 2) Perinatal Regionalization, and all four Strategic Research Issues and priorities of the Maternal and Child Health Bureau (MCHB).Publications
Listed is descending order by year published.
Clark RE, Weinreb L, Flahive JM, Seifert RW. Homelessness contributes to pregnancy complications. Health Affairs, 38(1),139-146,2019.
Clark RE, Weinreb L, Flahive JM, Seifert RW. Infants exposed to homelessness: health, health care use, and health spending from birth to age six. Health Aff (Millwood). 2019 May;38(5):721-728.
Clark RE, Weinreb L, Flahive JM, Seifert RW. Healthcare utilization and expenditures of homeless family members before and after emergency housing. Am J Public Health. 2018;108(6):808-814.
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